Most training posts are filled, but 2000 trainee doctors may still be jobless in October

By the end of the first round of this year's controversial training application process, 85% of doctors' training posts in England handled through the computerised medical training application service (MTAS) were filled.

The Department of Health has published the numbers of applicants competing for posts and of posts filled. It has collated data from individual deaneries after its national computerised system was scrapped halfway through the application process.

Deaneries have filled 13168 posts so far. Of these, 10804 are run-through training posts (entailing several years of training after the foundation programme and in which doctors train to specialise in either general practice or a specialty), 2262 are fixed term service training appointments (FTSTAs) (year long posts that must be applied for separately), and 102 are academic posts. Altogether, 2386 jobs remained to be filled at the end of round one.​one.

However, the situation is changing daily, because someone who has accepted an FTSTA post on round one but is then offered a run-through post (which is more likely to lead eventually to a consultant post) in round two can forgo the FTSTA post and opt for the run-through one instead.

It looks as though as many as 2000 doctors currently at foundation year 2 (F2) or senior house officer level may still be jobless at the end of the second round. However, the health department says it is planning to make around 1000 FTSTA posts available at the end of round two for those applicants who have still not secured a job. The exact number of additional posts has yet to be finalised.

The Modernising Medical Careers team has confirmed that of the 32649 eligible applicants for posts in the United Kingdom 16670 were UK graduates (69% of whom have accepted a post) and 15979 were UK based applicants who had obtained their medical degree outside the UK (29% of whom have accepted a post).

The statistics for England alone show that of the 27849 eligible applicants, 5000 were already in foundation year 2 (F2) posts. Seventy per cent of these (3500) have already accepted posts, leaving 1500 without jobs at the moment. About 900 of the 2320 vacant posts in England are at the second year of specialty training (ST1) level, suggesting that some 600 F2 doctors may not be able to find an ST1 post in round two.

The number of senior house officer applicants is 9700, of whom 5820 (60%) have already accepted posts, leaving 3880 who may not have a job from August. Although there are still 1420 vacancies at more senior levels (ST2, 3, and 4), more than 1600 senior house officers could be jobless when round two ends.

A further 10750 applicants who were neither senior house officers nor in F2 but who are currently working in the NHS also applied. These applicants could be in staff or associate specialist posts. Of these, 3225 (30%) have accepted jobs.

The health department has said that the highest numbers of unfilled posts are in anaesthetics, obstetrics and gynaecology, paediatrics, psychiatry, and geriatric medicine.

In England, 380 anaesthesia posts had not been filled, including 120 at ST1 level and 252 at ST2 level. Psychiatry has 280 unfilled vacancies.

But there is unlikely to be a problem filling these posts. In round one there were nearly 700 applicants for anaesthesia and more than 3000 applicants for psychiatry.

The BMA has pointed out that the proportion of academic trainee posts filled, at 57%, was rather lower than the other types of post. And some deaneries have achieved much lower fill rates than others, such as Trent, which has filled only 64% of posts.​posts.

Jo Hilborne, chairwoman of the BMA's Junior Doctors Committee, warned that it was still “alarmingly unclear” what would happen at the end of the month when junior doctors' contracts end.

She said, “The last health secretary [Patricia Hewitt] gave a commitment that they [junior doctors] would be able to continue their NHS employment; we expect the new one [Alan Johnson] to explain exactly how he will make this a reality. If trusts do not have adequate plans in place for 1 August, wards may be understaffed and operations cancelled.”

Matthew Jameson-Evans from Remedy UK, the group that has challenged the changes to the application system, said he was amazed that the health department had presented the statistics as a success story.

“They are saying it is 85% across the board, but we know that in some places it is 65%, and there must be some specialties which are below 50%.”

Notes

Up to date information on the current number of vacancies is available at www.mmc.nhs.uk.

Articles from The BMJ are provided here courtesy of BMJ Publishing Group